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Research gives hope to patients with serious angina

8 September 2016

A study carried out at the Trust, in partnership with Imperial College London, suggests that a treatment that is usually given to patients with dangerously high cholesterol could have a role to play in the treatment of refractory angina.

Refractory angina is a serious type of angina which is resistant to treatment with medication and revascularisation with stents and/or surgery. The results of the study were presented in a late breaking trial session at the European Society of Cardiology Congress 2016, which was held in Rome.

The research, led by specialist registrar Dr Tina Khan, and supervised by Dr Mahmoud Barbir and Professor Dudley Pennell, found that lipoprotein apheresis, a procedure that circulates blood outside the body to remove cholesterol and then returns it back to the body, had a significant impact on patients with refractory angina along with raised levels of lipoprotein(a). Lipoprotein apheresis is normally used to reduce cholesterol levels in patients with an inherited heart condition called familial hypercholesterolemia, which can cause early heart disease and lead to premature death. Lipoprotein(a) is a strong risk factor for coronary disease.

Dr Khan explains, “For patients suffering with refractory angina, treatment options can be limited. Our trial provides the first evidence that lipoprotein apheresis leads to an improvement in myocardial blood flow and a reduction in symptoms for these patients, leading to an improvement in their quality of life. The results suggest that this could be a much-needed new treatment option for patients with this challenging condition.”

The trial involved 20 patients with refractory angina with raised lipoprotein(a). Patients were given either lipoprotein apheresis or a placebo treatment for three months and were then swapped over for three months, with a month’s break  in-between. A significant improvement in symptoms was experienced when given lipoprotein apheresis  compared to  the placebo. The trial was the first to look at the impact of lipoprotein apheresis on patients with refractory angina and raised lipoprotein(a)

The familial hypercholesterolemia service at Harefield Hospital provides patients with lipoprotein apheresis treatment. The service also screens family members who may be at risk of having the condition.

In addition, the complex coronary disease and refractory angina service, at both Royal Brompton and Harefield hospitals, treats patients with refractory angina.

Find out more about the familial hypercholesterolemia service.

Find out more about lipoprotein apheresis treatment.

Find out more abut the complex coronary disease and refractory angina service.

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